Therapeutic choice for craniofacial venous malformations
Therapeutic choice for craniofacial venous malformations
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DOI：
10.1097/00001665-200607000-00025
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发表时间：
2006-07-01
影响因子：
0.9
通讯作者：
Hirano, Akiyoshi
中科院分区：
文献类型：
--
作者：
Akita, Sadanori;Akino, Kozo;Hirano, Akiyoshi
尽管静脉畸形的确切机制尚不清楚，但其临床表现有时会威胁到咀嚼、气道和语音等生命体征。1998年3月至2006年2月，共收治颅面静脉畸形患者11例，年龄15-59岁，平均32.4 ± 13.60岁，其中男7例，女4例。所有病例在临床随访期间至少经历过一次某种手术。用锝-99 mSri胶体标记的直接穿刺动脉造影显示所有病例均存在低血流畸形。2例行骨科手术，2例因面神经麻痹行静态悬吊术。单纯手术失血量为1352 ± 1115.0 mL，同期手术失血量为400 ± 244.9 mL，单纯硬化治疗失血量为187 ± 284.8 mL（单纯手术vs单纯硬化治疗，P < 0.01）。当畸形局限且硬化治疗次数明显少于良好病例时为硬化治疗优秀病例（优、良分别为1.3 ± 0.58倍和3.6 ± 1.15倍，P < 0.05）。虽然理解其机制存在困难，需要多种治疗干预，迄今为止已经取得了令人满意的结果，并且更好的硬化剂或实时导航系统的开发可能有利于更精确的治疗效果和更低的发病率。
Even though the precise mechanisms related to venous malformation are still unclear, the clinical manifestations sometimes threaten vital signs such as mastication, airway and phonics. Our therapeutic modalities were reviewed, and their effectiveness and related complications were analyzed.Between March, 1998 and February, 2006, 11 patients (15-59 years old; average 32.4 +/- 13.60, 4 women and 7 men) with craniofacial venous malformation were included in this investigation. All cases experienced some kind of surgery at least once during clinical follow-up. Direct puncture scintigraphy with technetium-99m Sri colloid-labeled demonstrated low-flow malformations in all cases. Two cases underwent bone surgery and another two cases had static suspensions for facial nerve paralysis. Blood loss from surgery alone was 1352 1115.0 mL, simultaneous procedures yielded 400 244.9 mL blood loss and sclerotherapy alone resulted in 187 +/- 284.8 ml, of blood loss (surgery alone versus sclerotherapy alone, P < 0.01). Excellent sclerotherapy cases were when the malformation was localized and the number of sclerotherapies was significantly fewer than good cases (1.3 +/- 0.58 times versus 3.6 +/- 1.15 times, excellent, good, respectively, P < 0.05).Although there are difficulties in understanding the mechanisms and multiple therapeutic interventions are required, there have been satisfactory outcomes so far and the development of better sclerosants or a real-time navigation system may benefit more precise therapeutic effects and lower morbidity.